超声引导经上盏径路微创经皮肾镜碎石术（附76例报告）

目的探讨超声引导下经上盏径路微创经皮肾碎石术（MPCNL）治疗上尿路结石的疗效及安全性。方法2006年3月至2009年3月，对76例82侧上尿路结石使用超声引导下经上盏径路MPCNL。穿刺点选择在肩胛下线和腋后线之间第10、11肋间，超声定位下穿刺后组上盏建立通道，使用U-100双频双脉冲Nd：YAG激光碎石。结果82侧手术均获成功，平均手术时间（45±10）min。一期结石取净率为81.7％（67/82），二期结石取净率为73.3％（11／15）。输血1例，胸腔积液2例，无重要脏器损伤及其他严重并发症。结论超声引导下经上盏径路微创经皮肾镜碎石术高效、微创、安全。

Upper pole access for minipercutaneous nephrolithotomy under B-ultrasound guidance(76 cases report)

Objective To investigate the efficacy and safety of upper pole access for minipercutaneous nephrolithotomy(MPCNL) under B-ultrasound guidance for upper urinary calculi treatment. Methods From March 2006 to March 2009, we treated 82 units(76 patients) of upper urinary calculi by upper pole access for MPCNL under B-ultrasound guidance.The skin puncture point had been located in this scope: the 10th or 11th intercostals, inner from postaxillary line and out of infrascapular line. The targeted puncture access is superior posterior calyx under B-ultrasound guidance. The lithotripsy device which we employed was U-100 Frequency-Doubled Double-Pulse Nd:YAG laser. Results 82 procedures were all successful. The average operation time is(45±10)min. Stone-free rate is 81.7%(67/82) for single procedure, and 73.3%(11/15)for secondary stage. 1 case had blood transfusion and 2 cases had hydrothorax. The patients had no important organ injury and no other severe complications. Conclusions The upper pole access for MPCNL under B-ultrasound guidance is a high efficient, micro-invasive , safe technique with high performance.